U.S. flag

An official website of the Department of Health and Human Services

SHARE:

FacebookXEmail AHRQPrintShare
Diagnostic Safety and Quality

Improved Diagnostic Accuracy Through Probability-Based Diagnosis

References

  1. Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. Balogh EP, Miller BT, Ball JR, eds. Washington, DC: National Academies Press; 2015. https://www.ncbi.nlm.nih.gov/books/ NBK338596/. Accessed August 31, 2022.
  2. Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med. 2005;165(13):1493-9. https://pubmed.ncbi.nlm.nih.gov/16009864/. Accessed August 31, 2022.
  3. Weatherall M. Information provided by diagnostic and screening tests: improving probabilities. Postgrad Med J. 2018;94(1110):230-5. https://pubmed.ncbi.nlm.nih.gov/29133377/. Accessed August 31, 2022.
  4. Graber ML, Holmboe E, Stanley J, Danielson J, Schoenbaum S, Olson APJ. A call to action: next steps to advance diagnosis education in the health professions. Diagnosis (Berl). 2021;9(2):166-75. https://pubmed.ncbi.nlm.nih.gov/34881533/. Accessed August 31, 2022.
  5. Pauker SG, Kassirer JP. The threshold approach to clinical decision making. N Engl J Med. 1980; 302(20):1109-17. https://www.nejm.org/doi/10.1056/NEJM198005153022003. Accessed August 31, 2022.
  6. Olson A,  Rencic J, Cosby K, Rusz D, Papa F, Croskerry P, Zierler B, Harkless G, Giuliano MA, Schoenbaum S, Colford C, Cahill M, Gerstner L, Grice GR, Graber ML. Competencies for improving diagnosis: an interprofessional framework for education and training in health care. Diagnosis (Berl). 2019;6(4):335-41. https://pubmed.ncbi.nlm.nih.gov/31271549/. Accessed August 31, 2022.
  7. Dahm MR, Crock C. Understanding and communicating uncertainty in achieving diagnostic excellence. JAMA. 2022;327(12):1127-8. DOI: 10.1001/jama.2022.2141. Accessed August 31, 2022.
  8. Meyer AND, Giardina TD, Khawaja L, Singh H. Patient and clinician experiences of uncertainty in the diagnostic process: current understanding and future directions. Patient Educ Couns. 2021;104(11):2606-15. https://pubmed.ncbi.nlm.nih.gov/34312032/. Accessed August 31, 2022.
  9. Korenstein, D, Scherer LD, Foy A, Pineles L, Lydecker AD, Owczarzak J, Magder L, Brown JP, Pfeiffer CD, Terndrup C, Leykum L, Stevens D, Feldstein DA, Weisenberg SA, Baghdadi JD, Morgan DJ. Clinician attitudes and beliefs associated with more aggressive diagnostic testing. Am J Med. 2022 Jul;135(7):e182-e193. https://pubmed.ncbi.nlm.nih.gov/35307357/. Accessed August 31, 2022.
  10. Baghdadi JD, Korenstein D, Pineles L, Scherer LD, Lydecker AD, Magder L, Stevens DN, Morgan DJ. Exploration of primary care clinician attitudes and cognitive characteristics associated with prescribing antibiotics for asymptomatic bacteriuria. JAMA Netw Open. 2022 May 2;5(5):e2214268. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142875/. Accessed August 31, 2022.
  11. McSherry D. Avoiding premature closure in sequential diagnosis. Artif Intell Med. 1997;10(3):269-83. https://pubmed.ncbi.nlm.nih.gov/9232189/. Accessed August 31, 2022.
  12. Ott DE. Words representing numeric probabilities in medical writing are ambiguous and misinterpreted. JSLS. 2021;25(3):e2021.00034. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325478/. Accessed August 31, 2022.
  13. Bergl PA. Pseudo-probabilistic aphorisms. J Grad Med Educ. 2018;10(6):709-10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314368/. Accessed August 31, 2022.
  14. Morgan DJ, Scherer LD, Korenstein D. Improving physician communication about treatment decisions: reconsideration of “risks vs benefits.” JAMA. 2020;324(10):937-8.
  15. Bours MJ. Bayes’ rule in diagnosis. J Clin Epidemiol. 2021;131:158-60. https://pubmed.ncbi.nlm.nih.gov/ 33741123/. Accessed August 31, 2022.
  16. Djulbegovic B, van den Ende J, Hamm RM, Mayrhofer T, Hozo I, Pauker SG; International Threshold Working Group (ITWG). When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation. Eur J Clin Invest. 2015;45(5):485-93. https://pubmed.ncbi.nlm.nih.gov/ 25675907/. Accessed August 31, 2022.
  17. Morgan DJ, Pineles L, Owczarzak J, Magder L, Scherer L, Brown JP, Pfeiffer C, Terndrup C, Leykum L, Feldstein D, Foy A, Stevens D, Koch C, Masnick M, Weisenberg S, Korenstein D. Accuracy of practitioner estimates of probability of diagnosis before and after testing. JAMA Intern Med. 2021;181(6):747-55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022260/. Accessed August 31, 2022.
  18. Cooper N, Bartlett M, Gay S, Hammond A, Lillicrap M, Matthan J, Singh M; UK Clinical Reasoning in Medical Education (CReME) consensus statement group. Consensus statement on the content of clinical reasoning curricula in undergraduate medical education. Med Teach. 2021;43(2):152-9. https://pubmed.ncbi.nlm.nih.gov/33205693/. Accessed August 31, 2022.
  19. Noguchi Y, Matsui K, Imura H, Kiyota M, Fukui T. Quantitative evaluation of the diagnostic thinking process in medical students. J Gen Intern Med. 2002;17(11):839-44. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC1495132/. Accessed August 31, 2022.
  20. Brighton H, Gigerenzer G. Homo heuristicus: less-is-more effects in adaptive cognition. Malays J Med Sci. 2012;19(4):6-16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629675/. Accessed August 31, 2022.
  21. Djulbegovic B, Hozo I, Beckstead J, Tsalatsanis A, Pauker SG. Dual processing model of medical decision-making. BMC Med Inform Decis Mak. 2012 Sep 3;12:94. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3471048/. Accessed August 31, 2022.
  22. Dale AP, Marchello C, Ebell MH. Clinical gestalt to diagnose pneumonia, sinusitis, and pharyngitis: a meta-analysis. Br J Gen Pract. 2019;69(684):e444-e453. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582453/. Accessed August 31, 2022.
  23. Xu H, Ang BWG, Soh JY, Ponnamperuma GG. Methods to improve diagnostic reasoning in undergraduate medical education in the clinical setting: a systematic review. J Gen Intern Med. 2021;36(9):2745-54. https://pubmed.ncbi.nlm.nih.gov/34159542/. Accessed August 31, 2022.
  24. Hoffrage U, Gigerenzer G. Using natural frequencies to improve diagnostic inferences. Acad Med. 1998;73(5):538-40. https://pubmed.ncbi.nlm.nih.gov/9609869/. Accessed August 31, 2022.
  25. Johnson KM. Using Bayes’ rule in diagnostic testing: a graphical explanation. Diagnosis (Berl). 2017;4(3):159-67. https://pubmed.ncbi.nlm.nih.gov/29536931/. Accessed August 31, 2022.
  26. Zipkin DA, Umscheid CA, Keating NL, Allen E, Aung K, Beyth R, Kaatz S, Mann DM, Sussman JB, Korenstein D, Schardt C, Nagi A, Sloane R, Feldstein DA. Evidence-based risk communication: a systematic review. Ann Intern Med. 2014;161(4):270-80. https://www.acpjournals.org/doi/10.7326/M14-0295. Accessed August 31, 2022.
  27. Hysong S.J. Meta-analysis: audit and feedback features impact effectiveness on care quality. Med Care. 2009;47(3):356-63. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170834/. Accessed August 31, 2022.
  28. Ebbinghaus EE. Memory: A Contribution to Experimental Psychology. Ruger HA, Bussenius CE, translators. New York, NY: Dover; 1964.
  29. Moffett J, Armitage-Chan E, Hammond J, Kelly S, Pawlikowska T. “It’s okay to not know …” a qualitative exploration of faculty approaches to working with uncertainty. BMC Med Educ. 2022;22(1):135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887020/. Accessed August 31, 2022.
  30. Ebell MH, Locatelli I, Senn N. A novel approach to the determination of clinical decision thresholds. Evid Based Med. 2015;20(2):41-7. https://pubmed.ncbi.nlm.nih.gov/25736042/. Accessed August 31, 2022.
  31. Girard C, Ecalle J, Magnan A. Serious games as new educational tools: how effective are they? A meta-analysis of recent studies. J Comput Assist Learn. 2012;29(3):207-19. https://doi.org/10.1111/j.1365-2729.2012.00489.x. Accessed August 31, 2022.
  32. Graafland M, Dankbaar M, Mert A, Lagro J, De Wit-Zuurendonk L, Schuit S, Schaafstal A, Schijven M. How to systematically assess serious games applied to health care. JMIR Serious Games. 2014;2(2):e11. https://games.jmir.org/2014/2/e11/. Accessed August 31, 2022.
  33. Mohan D, Farris C, Fischhoff B, Rosengart MR, Angus DC, Yealy DM, Wallace DJ, Barnato AE. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial. BMJ. 2017 Dec 12.359:j5416. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC5725983/. Accessed August 31, 2022.
  34. Mohan D, Schell J, Angus DC. Not thinking clearly? Play a game, seriously! JAMA. 2016;316(18):1867-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654519/. Accessed August 31, 2022.
  35. Stephens GC, Rees CE, Lazarus MD. Exploring the impact of education on preclinical medical students’ tolerance of uncertainty: a qualitative longitudinal study. Adv Health Sci Educ Theory Pract. 2021;26(1):53-77. https://pubmed.ncbi.nlm.nih.gov/32378150/. Accessed August 31, 2022.
Page last reviewed September 2022
Page originally created September 2022

Internet Citation: References. Content last reviewed September 2022. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/diagnostic-safety/resources/issue-briefs/probabilistic-thinking5.html

Click to copy citation